Background Fibroadenomas are benign breast tumors that are commonlydiagnosed in young women and are associated with a slight increasein the risk of breast cancer. These lesions vary considerablyin their histologic characteristics. We assessed the correlationbetween the histologic features of fibroadenomas and the riskof subsequent breast cancer.
Methods We conducted a retrospective cohort study of a consecutiveseries of patients with fibroadenoma diagnosed between 1950and 1968. Follow-up data were obtained for 1835 patients (90percent of those eligible). Fibroadenomas with cysts, sclerosingadenosis, epithelial calcifications, or papillary apocrine changeswere classified as complex. The rate of subsequent breast canceramong the patients was compared with the rates in two controlgroups, women listed in the Connecticut Tumor Registry and womenchosen from among the patients' sisters-in-law.
Results The risk of invasive breast cancer was 2.17 times higheramong the patients with fibroadenoma than among the controls(95 percent confidence interval, 1.5 to 3.2). The relative riskincreased to 3.10 among patients with complex fibroadenomas(95 percent confidence interval, 1.9 to 5.1) and remained elevatedfor decades after diagnosis. Patients with benign proliferativedisease in the parenchyma adjacent to the fibroadenoma had arelative risk of 3.88 (95 percent confidence interval, 2.1 to7.3). Patients with a family history of breast cancer in whomcomplex fibroadenoma was diagnosed had a relative risk of 3.72,as compared with controls with a family history (95 percentconfidence interval, 1.4 to 10). Two thirds of the patientshad noncomplex fibroadenomas and no family history of breastcancer and did not have an increased risk.
Conclusions Fibroadenoma is a long-term risk factor for breastcancer. The risk is increased in women with complex fibroadenomas,proliferative disease, or a family history of breast cancer.
Source Information
From the Departments of Preventive Medicine (W.D.D., W.D.P., M.S.R., P.A.S.) and Pathology (D.L.P., F.F.P., C.L.V.-J.), Vanderbilt University School of Medicine, Nashville.
Address reprint requests to Dr. Dupont at Vanderbilt University School of Medicine, Department of Preventive Medicine, A-1124 Medical Center N., Nashville, TN 37232-2637.
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